2020 Summer Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Once this form is received and processed an invoice will be emailed to the email listed below. Payment can be made online through the invoice or on the first day of camp. Dancers will not be able to participate in any camp activities without payment being made. We can't wait to see you this summer!

Camps run 9:00 - 4:00pm
Dancers provide their own lunch except Friday (Pizza Lunch)
1 Week - $340, 2 Weeks - $600, 3 Weeks - $870, 4 Weeks - $1,100, 5 Weeks - $1,300
Virtual Camp - 1 Week - $310, 2 Weeks - $565, 3 Weeks - $830, 4 Weeks - $1,055

Dancer's First and Last Name *

Dancer D.O.B *

YYYY

Parent/Guardian First and Last Name *

Parent/Guardian Email: *

Cell Phone Number *

Any Injuries or Illness? *

Select Type of Camp *

In Person at impact performing arts studio

Virtual (Don't forget to pick up your arts & crafts box)

Required

Select Camps *

July 20 - 24 Everything Dance Camp Ages 7-18

July 27 - 31 Dance Technique Camp Ages 7-18

Aug 3 - 7 Back to Basics Camp Ages 7-18

Aug 10 - 14 Back To Basics Camp Ages 7-18

Required

Wavier

Participation in any Impact Performing Arts activity on or off site, and use of recreational facilities involves risk of accidental injury despite all safety precautions. Having been informed of the activities conducted by Impact Performing Arts, I/we, as individual or as a parent or guardian of the participants named herein, assume all risks and hazards incidental to the activities, and release from responsibility and agree to indemnify and hold harmless Impact Performing Arts, its officers, directors, independent contractors, volunteers and all employees for any illness or injury to me or my child or family members accruing during his/her/our participation in any activity or use of any recreational facility at or conducted by Impact Performing Arts. I also agree to the use of my child’s photo/video for Impact Promotional purposes.

Printing name below will serve as your signature.

I agree to the wavier above. Parent/Guardian (Print Name) *

Payment Options *

I want to pay online. Please send me an email invoice.

I will bring in a check, cash or credit card the first day of camp. (ONLY IN PERSON CAMP)

Questions

Please call or email with any questions or concerns. (240)-340-1635 or impactdwx@gmail.com

Official Use Only

SS ______________ CC ______________

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms